BACKGROUND Healthy diet is essential in the management of chronic kidney disease (CKD) and preventing related comorbidities. Food outlet access has been studied in the general population; however, the influence of the local food environment on dietary intake among people with CKD has not been evaluated. OBJECTIVES This study examined the associations of food outlet density and type of outlets with dietary intake in a multicenter cohort of racially and ethnically diverse patients with CKD. METHODS The Chronic Renal Insufficiency Cohort Study is a multicenter prospective study of patients with CKD that used a validated food frequency questionnaire to capture dietary intake at the baseline visit. This is a cross-sectional analysis of 2,484 participants recruited in 2003-2006 from seven Chronic Renal Insufficiency Cohort Study centers. Food outlet data were used to construct a count of the number of fast-food restaurants, convenience stores, and grocery stores per 10,000 population for each geocoded census block group. Multivariable linear and logistic regression models were used to evaluate the associations between measures of food outlet availability and dietary factors. RESULTS The proportion of participants living in zero-, low-, and high-food outlet density areas differed by gender, race or ethnicity, and income level. Among male subjects, living in areas with zero or the highest number of outlets was associated with having the highest caloric intakes in multivariable models. Male subjects living in areas with zero outlets consumed the highest levels of sodium and phosphorous. Female subjects living in areas with zero outlets had the lowest average intake of calories, sodium, and phosphorous. Among low-income female subjects, close proximity to more outlets was associated with higher calorie consumption. Among all participants, access to fast-food restaurants was not associated with an unhealthy diet score, and access to grocery stores was not associated with a healthy diet score. CONCLUSIONS Average caloric and nutrient intakes differed by outlet availability; however, there were no strong associations with type of food outlet. This should be considered when developing food-focused public health policies.

中文翻译：

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慢性肾病成人的邻里食品出口和膳食摄入量：慢性肾功能不全队列研究的结果

背景 健康饮食对于慢性肾脏病 (CKD) 的管理和相关并发症的预防至关重要。已在一般人群中研究了食品出口的使用情况；然而，当地食物环境对 CKD 患者膳食摄入量的影响尚未得到评估。目的 本研究在一个由不同种族和民族的 CKD 患者组成的多中心队列中检查了食品出口密度和出口类型与膳食摄入量的关联。方法 慢性肾功能不全队列研究是一项针对 CKD 患者的多中心前瞻性研究，该研究使用经过验证的食物频率问卷来获取基线访视时的饮食摄入量。这是对 2003-2006 年从七个慢性肾功能不全队列研究中心招募的 2,484 名参与者的横断面分析。食品店数据用于构建每个地理编码人口普查区块组每 10,000 人中快餐店、便利店和杂货店的数量。多变量线性和逻辑回归模型用于评估食品出口可用性和饮食因素之间的关联。结果 生活在零、低和高食品出口密度地区的参与者比例因性别、种族或民族以及收入水平而异。在男性受试者中，生活在零或最多出口数量的地区与多变量模型中的卡路里摄入量最高有关。生活在零出口地区的男性受试者摄入的钠和磷含量最高。生活在零出口地区的女性受试者的平均卡路里摄入量最低，钠和磷。在低收入女性受试者中，靠近更多网点与更高的卡路里消耗有关。在所有参与者中，进入快餐店与不健康饮食得分无关，进入杂货店与健康饮食得分无关。结论 平均热量和营养摄入量因出口可用性而异；然而，与食品店的类型没有很强的关联。在制定以食品为重点的公共卫生政策时，应考虑到这一点。进入杂货店与健康饮食评分无关。结论 平均热量和营养摄入量因出口可用性而异；然而，与食品店的类型没有很强的关联。在制定以食品为重点的公共卫生政策时，应考虑到这一点。进入杂货店与健康饮食评分无关。结论 平均热量和营养摄入量因出口可用性而异；然而，与食品店的类型没有很强的关联。在制定以食品为重点的公共卫生政策时，应考虑到这一点。